Oncology

We know that a diagnosis of cancer can be devastating and overwhelming. That is why we take the time at your initial consultation to go over all of the treatment options, goals of treatment,prognosis, side effects of treatment, and to answer any other questions you may have. Below are some Frequently Asked Questions about cancer and treatment.

What is cancer?

Cancer is the uncontrolled growth of abnormal cells in the body. There are many different types of cancer that have different behaviors such as how they invade into surrounding tissues or spread through the body. While some cancers may not be curable, many are treatable with early diagnosis.

Will my pet be sick with chemotherapy?

Our goal with treatment is to ensure our patients maintain a good quality of life while undergoing cancer treatment. Most animals tolerate chemotherapy very well compared to humans. If a patient has a side effect from chemotherapy, we often reduce the dose the next time so it doesn’t happen again.

What side effects will I see if my pet is treated with chemotherapy?

Chemotherapy kills rapidly dividing cells, which are the cancer cells, however, normal cells in the body such as the gastrointestinal tract and bone marrow are also rapidly dividing and therefore be affected. Gastrointestinal side effects include nausea, vomiting, diarrhea, or loss of appetite, these are typically self-limiting and can be managed with at home medications. Bone marrow suppression decreases their white blood cell count predisposing them to an infection which clinically presents as lethargy and/or fever. We monitor their blood work closely throughout treatment and prescribe appropriate medications if side effects occur.

Will my pet lose their hair?

Cats and most dogs will not lose their hair during chemotherapy treatment. Only pets with true hair, not fur, such as those that need to be groomed regularly will lose some of their hair. Cats and dogs will lose their whiskers. Upon completion of the chemotherapy protocol, their hair will start to grow back.

How is chemotherapy given?

It depends on the chemotherapy drug that is chosen based on the type of cancer, but they are either administered by injection into a vein or by mouth in a treat.

What is radiation therapy?

Radiation therapy is commonly done by a machine called a linear accelerator which produces x-ray beams that are directed at the tumor. It is commonly used to treat tumors in the surgically inaccessible locations or other areas where residual tumor cells are still present after surgery. If your pet needs radiation therapy, we would refer you to a board-certified radiation oncologist that we work closely with for the treatments.

What is palliative care?

Palliative care is meant to improve your pet’s quality of life by preventing and treating the symptoms and side effects of their cancer and its treatment. Palliative care is given throughout your pet’s experience with cancer, beginning at diagnosis and continuing during treatment, follow-up care, and the end of life.

Lymphoma is the most common cancer that occurs in both dogs and cats. It originates from a mutation in a type of white blood cell called a lymphocyte, which then proliferates and can affect tissues such as the lymph nodes, liver, spleen, and bone marrow. We rarely are able to cure the disease but we are able to manage it with chemotherapy, as most patients will go into a complete remission (no visible signs of cancer) with treatment.

Here are some FAQs about the diagnosis and treatment of Lymphoma:

What are the stages of Lymphoma?

There are 5 stages of lymphoma. Stage I is a single lymph node affected. Stage II is 2 or more lymph nodes affected on one side of the diaphragm. Stage III is generalized lymph node involvement. Stage IV is the involvement of the liver and/or spleen. Stage V is involvement anywhere else in the body such as blood, bone marrow, eyes, intestine, skin, or central nervous system. Stage I & II are very rare. Most patients are Stage III or IV at diagnosis. For the majority of cases, stage is not prognostic, however certain locations may not be as responsive to treatment.

What is the best treatment for multi-centric canine Lymphoma?

A multi-drug protocol known as CHOP is the gold standard treatment for lymphoma. At Saint Francis Veterinary Specialists this is a 19week protocol, with treatments administered once weekly with every 5th week being a break off chemotherapy. There are other chemotherapy options that are less frequent and less expensive, however, they do not have as good of response rates or survival times compared to CHOP. We can discuss these options during your initial consultation.

Will my pet be cured with treatment?

The goal of lymphoma treatment is remission, not necessarily cure. With the CHOP chemotherapy protocol, approximately 90% of dogs will go into a remission with a median survival time of about 1 year from diagnosis. Once your pet is evaluated by an oncologist, certain prognostic factors may be discovered that will aid in predicting the prognosis for each individual patient.

Mast cell tumors are one of the most common skin tumors that occurs in dogs. Mast cells are a type of immune cell, they contain histamine and heparin granules and are normally found in many areas of the body, including the skin. They play a role in allergic and immune responses. Degranulation of tumor cells can occur with manipulation, causing reddening of the skin, coagulation abnormalities, hypotension (low blood pressure) and anaphylaxis. Recommended treatments for mast cell tumors depend on the grade as well as whether or not they have spread to other locations.

Here are FAQs about the diagnosis and treatment of Mast cell tumors:

What is the behavior of mast cell tumors?

The grade of the tumor, which is determined by the pathologist after removal and submission of the tumor is the most important predictor of behavior. There are currently two grading systems (1-3 and low or high) that are used by pathologists and oncologists to help predict behavior. Some low-grade tumors can be cured with surgery whereas higher grade tumors have a higher chance of coming back and spreading to other locations.

What staging tests may be recommended?

Staging tests will depend on the grade of the tumor as well as its location but may include full bloodwork, sampling of the local draining lymph node, x-rays, and abdominal ultrasound.

What is the treatment of choice?

The treatment of choice for mast cell tumors (regardless of grade) is surgical resection. When it cannot be completely excised additional local treatment with radiation therapy may be recommended. For high-grade tumors that are more likely to spread, chemotherapy would also be recommended.

Osteosarcoma is the most common bone cancer that occurs in dogs. It typically occurs in large or giant breed dogs. It is locally invasive causing changes to the bone (both destruction and proliferation) and is highly metastatic (meaning that it will likely spread to other parts of the body). The changes to the bone are painful leading to clinical signs such as lameness, pain, and even fracture.

Here are some FAQs about the diagnosis and treatment of Osteosarcoma:

What is the best treatment for Osteosarcoma?

Surgery to remove the bulk of the tumor and source of the pain is the first step in treatment, this is usually by amputation of the limb. Due to the high rate of spread, injectable chemotherapy following surgery is strongly recommended.

How will my dog’s quality of life be with only three legs?

Most dogs do excellent after an amputation after an initial adjustment period. Prior to surgery, our team will evaluate whether your pet is a good candidate by performing thorough neurologic and orthopedic exams.

What is my dog’s prognosis with treatment?

Unfortunately, cure of this cancer is unlikely given its very high rate of spread to other parts of the body even when none is detected at diagnosis. However, with surgery followed by chemotherapy, we can improve your dog’s quality of life and extend their survival time to approximately 10-12months.